BACKGROUND: In 2006, nearly 400,000 women in the United States underwent a surgical procedure to correct stress urinary incontinence (SUI), and experts expect that number to grow over the next several years. SUI is a condition that that causes involuntary leakage of urine during activities like laughing, coughing, sneezing and exercise or recreational activities. One of the biggest risk factors for the condition is childbirth. This is because childbirth sometimes causes nerve damage to the pelvic floor muscles. SUI resulting from this damage may begin soon after delivery or years later. According to the Mayo Clinic, other risk factors for the condition include aging, menopause, obesity and previous pelvic surgery like a hysterectomy.

TREATMENTS: To treat stress urinary incontinence, doctors usually recommend behavior therapies first. Depending on the circumstances, these can include weight loss, smoking cessation, increased water intake and pelvic floor exercises called Kegels. Anticholigernics, or medicines that help relax bladder muscles, help some women with SUI. Side effects of the drugs include dry mouth, blurred vision, constipation, rapid heartbeat and flushing. Devices like a vaginal pessary -- a ring-shaped device that helps support the bladder -- offer relief to other women.

When behavior changes don't work, some women opt for surgery. Surgical options used in the treatment of SUI include suspension and sling procedures. In suspension, surgeons use surgical threads to help support the bladder neck. In the most common type of the procedure, an incision is made in the abdomen a few inches below the navel. Through that incision, the surgeon secures threads to strong ligaments within the pelvis. In sling procedures, surgeons place synthetic mesh materials midway along the urethra. They place the materials through several small incisions. Suspension and sling procedures are performed under either spinal/epidural anesthesia or general anesthesia.

Recent research performed by the Urinary Incontinence Treatment Network found two years after suspension or sling procedures, about two-thirds of women with a sling and about half of those with a suspension were cured of SUI (Source: National Institute of Diabetes & Digestive & Kidney Disease). Overall, 86 percent of women with a sling and 78 percent of women with a suspension said they were satisfied with the surgery results.

A SURGERY-FREE OPTION: During a new treatment called the Renessa System, doctors use a small probe to pass through the natural opening of the urethra while the patient is under local anesthesia. The probe is then used to heat several small sites at the bladder neck and upper urethra. The treatments cause the collagen in the tissue to "reorganize." When the sites heal, the tissue is firmer and more resistant to leakage. Doctors hope to use the Renessa procedure in the future to improve results after non-successful surgeries for SUI. Experts estimate that over the next five years, about 700,000 women will experience sub-optimal results after such surgeries.